Individual
DR. DOUGLAS M TOLLEFSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL FL 7, 7TH FL, SAINT LOUIS, MO 63110-1032
(314) 362-8808
(314) 362-8826
Mailing address
660 S EUCLID AVE, C B 8125, SAINT LOUIS, MO 63110-1010
(314) 362-8808
(314) 362-8826
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
R9558
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201385101
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/14/2006
Last updated
01/29/2018
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